Psychosocial Safety Is Patient Safety: Gender-affirming Care as an Exemplar for Health Equity

Objective: Traditional patient safety has predominantly focused on preventing direct physical harm, such as falls and infections, often neglecting a critical aspect of safety: psychosocial safety. Yet preventable psychosocial harm—including the affective experience of pain; emotional harm; or social harm that may involve reputational, relational, or economic injuries—represents a pervasive threat to patient well-being that warrants research efforts and practice changes commensurate with the scope of the problem. Minoritized populations, particularly transgender and gender nonconforming (TGGN) patients, face heightened risks of psychosocial harm due to systemic biases and discrimination within health care systems. Methods: In this article, we focus on the experiences of TGGN patients to illustrate the pervasive nature of psychosocial harm and the urgent need for patient-centered care, which, in the case of TGGN care, is gender-affirming care. Results: We identify the need for systemic solutions to address psychosocial safety, including inclusive policies, education, and engagement with TGGN communities. We recommend taking a human-centered design approach to health care that prioritizes the needs of minoritized populations and aims to eliminate structural stigma. Conclusion: By integrating psychosocial safety into the broader patient safety framework, health care systems can create more equitable and compassionate environments that promote the well-being of all patients. There is no patient safety without psychosocial safety, and there is no psychosocial safety without equity.